Is it wise to use rib cartilage on primary rhinoplasty? Also should I augment my radix? (Photo)

Question

Hello I have consulted several surgeons for open rhinoplasty, and one has suggested that I won't have enough cartilage unless he harvests rib cartilage to support my drooping tip & augment the radix to improve the profile of my nose. I am interested but a little concerned as I have not seen this type of work around rhinoplasty. Any suggestions would be welcome. Thanks

Zoran Potparic, MD · Answer

Providing that this is your first rhinoplasty, you will have sufficient amount of cartilage in your septum to be used for all needed support (tip, columella, alar rim). It looks that shortening of the nose and tip rotation/elevation would be the most important part of your rhinoplasty; dorsum augmentation may not be needed at all. Good luck.

Oakley Smith, MD, FRCSC · Answer

It is not typical to use rib graft for a primary rhinoplasty as there usually is enough septal cartilage to use as graft material. However this depends on your particular case, and will depend on a surgeon's physical examination of your nose.

Ronald Schuster, MD · Answer

Cartilage in primary rhinoplasty is not too uncommon. It is used to provide support and improve the shape of the tip. It can also be used to increase the height of the dorsum (bridge) and to widen a very narrow nose. In most patients the cartilage can be taken from the septum or ear. In patients with very low dorsum and lack of tip support there might not be enough cartilage in those ares, so the ext choice is rib. This is common in ethnic rhinoplasty such as some African American and Asian patients.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. You are an excellent candidate for rhinoplasty, I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. In your case, I do not see any reason to use rib cartilage.  You have plenty of cartilage from your septum that can be used and definitely no need for rib. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Ronald J. Edelson, MD · Answer

You don't need cartilage graft at all to raise your tip there's actually a very simple way to do this. And it can be done as a closed rhinoplasty. I would get other opinions. Your rhinoplasty is straightforward. No need to complicate it

Cem Altindag, MD · Answer

Hi, thank you for the question. My recommendation is not to touch rib or ear area for first surgery. It is not necessary. For radix, it may need some filling during surgery, a little bit although evaluating limited images. Also, your expectations should be listened before surgery. Regards. OprDr Cem Altindag

Robert Ciardullo, MD · Answer

Do you need rib Cartlidge? You can have a reduction rhinoplasty with elevation of the nasal tip and elevation of your hanging columella with a closed rhinoplasty and no Cartlidge graphs at all. The best way to elevate the tip and hangingcolumella is to invaginate it up onto the caudal portion of your existing septum. This is the strongest and best support and works extremely well.

Is it wise to use rib cartilage on primary rhinoplasty? Also should I augment my radix? (Photo)

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